| NPI | 1952062283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063321) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MR7151145) |
| Enumeration Date | 2022-01-08 |
| Last Update Date | 2023-09-18 |